Surgical method and electrode therefor

ABSTRACT

A surgical electrode is described. This instrument is adapted to fit into a body cavity, to be directed by the surgeon to an operative area in the cavity and then to emit a cauterizing electric current. Several embodiments are disclosed. In one, a blind electrode is positioned and pulsed. In another, an electrode is coupled with optics to permit directing it by sight or by CRT display. In another, a forked or dual electrode is shaped to the body cavity and can be properly positioned with excellent reliability. Preferably, at least the portion of the instrument inserted in the body cavity is disposable. The present invention includes method and apparatus for female sterilization using the electrode for cauterization of fallopian tubes.

United States Patent 11 1 Lessen 1 Jan.7,l975

[76] Inventor: Martin Lessen, 9 ldlewood Rd.,

Rochester, N.Y. 14618 [22] Filed: June 1, 1973 [21] Appl. No.: 366,011

Related US. Application Data [63] Continuation-impart of Ser. No.123,194, March 11,

3,163,165 12/1964 lsikawa 128/303.17 3,294,085 12/1966 Wallace 128/63,357,433 12/1967 Fourestier et a1 l28/303.17

Primary Examiner-Aldrich F. Medbery Attorney, Agent, or Firm-Frank A.Steinhilper; Alfred H. Rosen [57] ABSTRACT A surgical electrode isdescribed. This instrument is adapted to fit into a body cavity, to bedirected by the surgeon to an operative area in the cavity and then toemit a cauterizing electric current, Several embodiments are disclosed.In one, a blind electrode is positioned and pulsed. In another, anelectrode is coupled with optics to permit directing it by sight or byCRT display. In another, a forked or dual electrode is shaped to thebody cavity and can be properly positioned with excellent reliability.Preferably, at least the portion of the instrument inserted in the bodycavity is disposable. The present invention includes method andapparatus for female sterilization using the electrode for cauterizationof fallopian tubes.

7 Claims, 15 Drawing Figures TO FLUID 4g SUPPLY I45 L TO CAUTERY POWERSUPPLY I44 TO LIGHT /43 SOURCE PATENTEDJAN SHEET 20F 4 /4 I I I I I I II I I I! PATENTED 3,858,586

SHEET 3 or a E TOF'D SUP Y/45 TO CAUTERY POWER SUPPLY /44 SURGICALMETHOD AND ELECTRODE THEREFOR CROSS-REFERENCE TO CO-PENDING APPLICATIONThis present application is a continuation-in-part of co-pending US.Pat. Application Ser. No. 123,194

filed Mar. 11, 1971 and now abandoned.

BACKGROUND OF THE INVENTION This invention relates to a new surgicalinstrument and to its use and operation.

This is a continuation-in-part of application Ser. No. 123,194 whereinit was disclosed that a fine electrode member is placed into a naturalbody cavity, the tip of the electrode positioned 'at a constricted pointof such cavity, and that the electrode tip then is energized to cause acauterizing spark. A consequence of the cauterizing spark is thecleaning or sterilization of the constriction or fine passageway. Onespecific consequence of such spark well within a fine passage is thatscar tissue forms, thus sealing, healing or blocking the passageway.Thus, if the passage is the consequence of an injury or other physicalor physiological defect, illness, infection or the like, the electrodecan be a healing mechanism. In one embodiment of the invention,'anatural passageway can be blocked by proper use of this electrode. Inparticular, fallopian tubes can be blocked by use of this electrode withthe consequence that female sterilization can be brought about. Thepresent invention is directed to such female sterilization.

At the present time, there is a great need for a quick, easy andeffective mechanism for female sterilization. This need is abundantlyclear in the United States and is perhaps even more pressing in othercountries, particularly, poverty striken countries. Birth control andpopulation reduction are easily and non-surgically accomplished by awide variety of means dependent on continual cooperation by the peopleinvolved. Sterilization, however, has generally been a serious surgicaloperation requiring hospitalization and use of a surgical operatingroom. Obviously, therefore, the need is clear for a sterilizationprocedure which can be carried out for example, in the doctors office.Even more pressing is the need for some form of mass sterilizationtechniques in which a doctor or a team of medical personnel can operatea sterilization technique at temporary field quarters. The presentinvention provides such a technique.

GENERAL NATURE OF THE INVENTION The present invention comprises asurgical electrode adapted to be operated for female sterilization byinsertion of an electrode tip well within the walls of the fallopiantubes. When properly positioned, the electrode is energized, causing aspark which in turn causes scar tissue, blocking the fallopian tube. Ahigh percentage of success can be achieved, and within a few days of theoperation, a clinical or medical test can be performed to determinewhether it was or was not successful. No hospital visit is required andthe operation can be carried out in a few minutes essentially painlesslyin the doctors office. If desired, clinic or field operations can becarried out to treat a large number of people quickly, easily,painlessly and effectively.

Operations intended to block fine passages such as fallopian tubes havebeen employed previously with a substantial lack of success, at leastfor the purpose of human sterilization. The problem is that side effectsmay result and also that sterilization is uncertain. In particular, ifblockage of the passage occurs essentially at the mouth of the passage,then there is too large a likelihood that the passage will not beeffectively blocked and that physiological disorders will result.Accordingly, in use of the electrode according to the present invention,it is essential that the tip of the electrode be sufficiently fine tofit well within the passage being blocked and it is essential that it beso positioned.

' SPECIFIC DESCRIPTION OF THE INVENTION The nature of the invention ismore particularly set forth and apparent from the drawings, in which:

FIG. 1 is a diagrammatic view of a surgical instrument according to oneembodiment of the invention;

FIG. 2 is an enlarged fragmentary view in crosssection of one form of anelectrode for the device of FIG. I;-

FIG. 3 is an enlarged fragmentary view in crosssection of another formof an electrode for the device of FIG. 1;

FIG. 4 is a side view of an electrode according'to an other embodimentof the invention;

FIG. 5 is a front view of the electrode of FIG. 4 in partly closedposition;

FIG. 6 is a front view of the electrode of FIG. 4 in open position;

FIG. 7 is a diagrammatic view of an electrode according to anotherembodiment of the invention;

FIG. 8 is a diagrammatic view of another form of an electrode;

FIG. 9'is a diagrammatic view of three electrode portions of anelectrode according to another electrode embodiment;

FIG. 10 is a view of a surgical electrode for sterilization according toanother embodiment of the invention;

FIG. 11 is a diagrammatic view of the operating end of the electrode ofFIG. 10;

FIG. 12 is the electrodev of one embodiment of the invention positionedto perform cautery inside a fallopian tube;

FIG. 13 is an enlargement in section of the end of the electrode of FIG.12;

FIG. 14 is an enlargement in section of the eyepiece efid of theelectrode of FIG. 12;

FIG. 15 is a cross section view of the assembly of FIG. 13.

The surgical instrument according to this invention may be a generalpurpose instrument, but preferably, it has shape and configurationspecifically adapting it to a single preferred type of application. Thepresently.

preferred device is adapted to sterilization of the female human beingor female animal, as the present invention now is believed to have asits most important aspects a method and instrument for sterilizatiomlncertain instances, it is desired to have simply a surgical electrodewhich can be manipulated to position its operative electrode tip at adesired position within a body cavity, which position can be readilydetermined by a practiced and experienced surgeon from a positionexternal to the body. In this situation, the experienced surgeon needmerely employ a single elongated electrode such as that shown in FIGS.1, 2 and 3 which he can, by practice, and experience, manipulate to thedesired position within the body cavity. In many instances, themanipulation can be assisted visually either by looking into the bodycavity from an external position or by optical means. In this way, forexample, it is possible to employ the surgical instrument for many.forms of corrective surgery where a relatively large body cavity isbeing treated or where a passage is accessible directly from outside thebody. Certain cysts and infected channels can be treated in this mannerand it is observed that electrical cauterization not only produceshealing scar tissue, but also cleans or sterilizes the passage beingtreated.

In many instances, however, it is necessary to treat a fine passagepositioned well within a cavity in the human body at a position whichcannot be readily located with accuracy from outside the body. In suchinstances, it may be desirable to employ the electrode combinationillustrated in FIG. 7. In this figure is illustrated a surgicalinstrument including a flexible maneu-.

verable electrode having an operable electrode tip and includingflexible optical means such as the fiber optics member illustrated inthe figure. The surgeon employing such an instrument can direct it to aprecise position within the body cavity and can with confidentassurance,.position the operable electrode tip at precisely the rightlocation for electric cauterization to produce the desired scar tissue.The surgical electrode according to this embodiment of the invention hasuniversal application and can be employed in the simplest of operationsat or near the surface of the body and in the most difficulty accessiblepositions within the most tortuous body cavities. It is to be observedin particular that this electrode can be employed deeply within nasalpassages or within the throat and even to the extent of being employedin the stomach or abdominal passages. Although certain embodiments ofsurgical electrodes according to this invention may be specificallydesigned for common surgical procedures repeatedly employing essentiallya standard technique, it is still possible to employ this embodiment ofthe invention including both operative electrode tip and optical meansin essentially any and all surgical procedures contemplated by thepresent invention.

In FIGS. 4, 5 and 6, there is also shown a special purpose surgicalelectrode which may be appropriately designed for an operation requiringtwo (or more than two) electric cauterizations in a standardizedsurgical operation which may be carried out time and time again. Such anoperation typically may be animal sterilization in which a predeterminedsize and shape electrode including at least two operative electrode tipsis appropriately positioned to trigger simultaneously two or moreelectric cauterization discharges which will produce scar tissueappropriately sealingfine body passages at uniformly predictablepositions within a body cavity. It is possible according to thisembodiment of the invention to produce simple, inexpensive surgicalelectrodes having a plurality of operable electrode tips and to producethese electrodes at a cost essentially the same as or perhaps even lessthan the cost of sterilization after use. Accordingly, a new and unused,and therefore sterilized, electrode may be employed on one animal andimmediately thrown away to permit the use of another new, and thereforesterilized, electrode for at least those portions of surgical apparatuswhich are employed within a body cavity.

' The use of the electric cauterization instrument and techniqueaccording to the present invention has many obvious advantages. Theprimary advantage is that a surgical result can be achieved at adifficultly accessible or otherwise inaccessible portion of the bodywithout cutting or surgically opening body tissue. In this way, it ispossible to accomplish surgery without hospitalization for operationswhich might otherwise require several or many days recuperation in ahospital.

Certain specific embodiments-of devices according to this invention areillustrated in the drawings accompanying this description. It is to beunderstood, of course, that various modifications will be obvious to oneskilled in the art.

FIG. 1 is a schematic representation'in very simple form of an electrodeaccording to the concept of this invention. As illustrated in FIG. 1,the device includes a handle 11 having an elongated flexible electrodetip 12. The handle may for example, have'gripping means 13 to permit itto be conveniently held in the hand of the surgeon. It may have anexternal electric cord 14 adapted to be plugged into a conventionalelectric outlet or it may have self-contained electric circuitrysuitable mounted within the handle. The flexible electrode 12 mayconsist of a double electrode wire as illustrated in other figuresorthere may be a ground lead 15 extending from the deviceand terminatingin a ground plate or clamp (not shown) adapted to be positioned againstthe skin of the animal or patient as close as possible to the point ofsurgery.

Conventionally mounted on the handle 11 is an electric switch or buttonwhich is adapted to be thrown or pressed to operate the electriccircuitry to produce a pulse at the tip of electrode 12 when desired. Itis understood that the circuitry to produce the pulse is completelyconventional and may comprise any desired electrical mechanism toproduce a pulse or spark at a tip of the electrode. A conventional highfrequency or a capacitance circuit may be triggered by switch or button16 to produce such a pulse and the circuit can be energized by aninternal battery-operated electric means or by electric meansconnectable to a conventional and convenient power outlet.

In FIG. 2 is shown in enlarged partial cross-section one form ofelectrode 12 of the device of FIG. 1. This flexible electrode comprisesan electrically conductive wire 21 terminating in a tip 22 andsurrounded by a plastic sheath 23. Desirably, the wire 21 islongitudinally moveable within the sheath and in such case, it is alsodesired that the wire 21 have a thin coating of plastic or otherinsulator along its length except the tip 22. In use and operation, theflexible electrode 12 is inserted into the body cavity until it is atthe desired position. Electrode wire 21 is then advanced in sheath 23,or sheath 23 is then retracted from the tip to assure proper mechanicalcontact with the tissue to be cauterized. When the tip is properlypositioned, switch or button 16 is activated to create an electric pulseor electric spark at tipp 22 of electrode 12.

In FIG. 3 is shown a modified and presently preferred embodiment offlexible electrode 12. According to this embodiment, a pair of insulatedwires 31 and 32 terminate in tips 33 and 34 and are encased in a plasticshield or sheath 35. The wires may or may not be longitudinally movablein the sheath 35. The electrode according to this embodiment of theinvention is employed in the same way as the electrode according to FIG.2. It

is inserted into the body cavity properly positioned and then anelectric pulse is generated to produce a spark or similar pulse betweenelectrode tip 33 and electrode tip 34 that produces electriccauterization of the tissue. The insulated conductors 31, 32 and tips33, 34 may be coaxial in geometry.

Size and shape of the flexible electrode 12 is material to the functionof the device, inasmuch as it relates significantly to size and shape ofa natural body cavity of a human or other animal. A purpose to beachieved by the present inventionis to permit easy and simple operationwithin a body cavity of an animal or human being and generally speaking,it is expected that such operations will be carried out within a tightlyconfined cavity or at a precisely positioned location within the cavity.Accordingly, the electrode 12 generally will be long enough to reachinto the body cavity and to the right location therein and to extendcompletely outside the cavity. For most purposes, the electrode will beroughly six to twelve inches long. Also, obviously, longer or shortermay be acceptable or necessary for certain purposes. In addition, theelectrode 12 generally will be quite thin and it will be only unusualcases that the width or diameter'of the electrode will exceed /8 inch orat the most A inch. Obviously, thicker electrodes can be used forcertain purposes, but the convenience of the present surgical instrumentgenerally will not be realized except with an extremely thin electrodewhich can reach positions within a body cavity where conventionalinstruments cannot find access. Likewise, electrode tips 33 and 34(where a dual electrode is used) should be positioned as close togetheras possible consistent with producing a workable and effective electricspark or electric pulse by the tips. Generally speaking, the electrodetips will be spaced a small fraction of an inch apart to produce ahighly concentrated localized pulse or spark, thus permitting accurateposition and location of the electric cauterization.

Generally speaking, the electrode 12 will have a spring-like resiliencypermitting it to be positioned within a body cavity without bending outof shape and without being'so rigid as to harm the tissue which itcontacts. This result can be achieved with'the use of conventionallyavailable spring steel electrode wires. The wires together with anelectrically insulating coating canbe appropriately thin and still havethe desired degree of strength and flexibility. Accordingly, it is to berealized that the sections of electrode 12 illustrated in FIGS. 2 and 3have been distorted in shape and do not represent a reasonable depictionof the preferred electrode length or preferred electrode dimensions.

In FIGS. 4 and 5 and 6 are illustrated another embodiment of theinvention employing a forked electrode adapted to cauterize locationswithin a body cavity. This form of the electrode is presently preferredfor an operation in which cauterization is desired at two predictablyspaced locations within a single body cavity. One preferred purpose ofthe instrument is cauterization of fallopian tubes and, accordingly, forthis purpose, the preferred instrument is that shown schematically inFIGS. 4, 5 and 6.

FIG. 4 illustrates the sideview of a bifurcated electrode generallydesignated 41. The electrode has a single body section 42 from whichextend two divergent electrode 43 terminating at electrode tips 44. Theelectrode illustrated in FIG. 4 tapers slightly from the body 42 to thetip 44 and generally curves gradually to conform with a typical bodycavity. As seen in FIG. 5, and FIG. 6, a sheath preferably a plasticsheath 46 retractably covers the two electrode sections 43 and canextend close to or if desired over electrode tips 44. The insulatedconductors are longitudinally movable within the electrodes 43 toadvance the tips 44 to their desired position.

In operation, the device according to FIG. 4 is first closed andprotected with sheath 46 extending essentially to the electrode tips. Itis then inserted into the body cavity after which sheath 44 is withdrawnto permit electrodes 43 to spread apart to their natural position. Thedevice is then manipulated by the skilled operator until electrode tips44 are both at the desired position and then the two electrodes 43 aresimultaneously or sequentially pulsed to produce a cauterizing electricpulse or spark at tips 44. Generally, it will be preferred to haveindividual operating electric circuits for each of electrodes 43 and toemploy dual wires in each as shown in FIG. 3. In this way, a firstelectrode 43 is energized to produce a cauterizing pulse and the pulsepreferably will be indicated by suitable dials, gauges or other signalsexternally positioned. After the first pulse has been produced at oneelectrode, a second pulse is produced at another electrode and again issignaled appropriately externally.

The device of FIG. 1 in conjunction with the electrodes shown in FIGS. 2through 6 can be extremely inexpensively manufactured particularly inmoderate or large quantities. Accordingly, their cost can be so low asto make it economically feasible for the electrodes to be used once andthrown away. Disposable electrodes, accordingly, are contemplated and itis to be expected thatat least that portion of the device which operateswithin the body cavity may be disposable to permit a single use,although, of course, the device may be sterilized and reused if sodesired.

In FIG. 7 is illustrated another embodiment of the invention includingself-contained optical means to permit a skilled operator or surgeon toposition the operating tip of the electrode by sight or by other visualmeans. As schematically illustrated in FIG. 7, a flexible protectivesheath 71 encases a plurality of electrode wires 72 suitably insulatedand positioned in generally the same manner as shown in the otherfigures. Also positioned within the sheath 71 is a fiber optics bundle73 for viewing the position of the electrode tips, optionally with asecond fiber optics bundle 73A to carry light into the body cavity toilluminate the field of vision. Optionally, bundle 73 can operate tocarry light both ways and to serve both the illumination and viewingpurposes. Near the end of the fiber optics bundle 73 is an opticalimaging means such as a maneuverable mirror 74 which may, for example,be rotatable around pivot 75. A control mechanism such as a control wire76 can adjust the mirror 74. Optionally, an outer disposable sheath 78permits a flow of water or other fluid to the end of the electrode toflush out the field of vi- SlOn.

Associated with the electrode of FIG. 7 can be extremely small lightsources or other devices to assist in viewing and positioning theelectrode tip. In use and operation, after the electrode of FIG. 7 isproperly positioned, sheath 71 may be partially retracted to bringelectrode 72 into the proper location and the electrode may then bepulsed.

The surgical instrument according to the present invention can beemployed for any desired electrical cauterization operation within thebody cavity of a human being or other animal. The presently preferredpurpose, however, is in connection with female sterilization for birthcontrol where it is expected that a simple and convenient operation canbe performed in a few minutes withoutthe necessity for incision withother surgical instruments. It is also expected that a careful, skilledoperator can achieve a successful result in excess of 95 percent of theoccasions of use. Furthermore, with a medical check after the operationto detect incomplete success, it is expected that essentially 100percent effectiveness can result from a single or once-repeatedoperation. It is also expected that the cost of such operation both interms of money and in terms of patient care can be reduced perhaps atleast to about 1 percent of the time and cost of conventionaloperations. 7

In FIG. 8 is shown another form of electrode probe according to thisinvention including an elongated electrode body 81 which may be one ofthe electrodes of a previous figure such as the electrode of FIG. 7. Theelectrode body 81 has electrode tips 82 at the point thereof and means(not shown) for pulsing the tips. An outer sheath 83 retractably coverselectrode body 81. At the end of the sheath furthest from the tip is aring or handle 84 forming a finger grip to retract the sheath from theelectrode tip and a cooperating base or finger grip 85 on the electrodebody forms convenient means associated with the electrode to expose theelectrode tips in operative position for a cauterizing electric pulse.

in FIG. 9 is shown diagrammatically a portion of an electrode adapted tobe positioned within a disposable plastic sheath like, for example, theelectrode of FIG. 7, or adapted to be encased in a plastic shield like,for example, the electrode structure-of FIG. 3. In FIG. 9, a pair ofelectrodes 91 and 92 are positioned on each side of a central electrode93. The tip of central electrode is a ring tip 94. All but the tips ofelectrodes 91 and 92 are insulated, preferably being covered withplastic insulators 95 and 96 which may, if desired, be a single unitaryelongated plastic body in which are embedded the three electrodes 91, 92and 93. If electrode 93 is not embedded in a plastic body, it is coveredalong its length with insulator 97.

in FIGS. and 11 is illustrated a specific electrode structure expresslydesigned for a surgical or medical method or process of rendering thehuman female sterile. In FIG. 10 is illustrated a fiber optic core,generally designated 101 for a surgical electrode specifically adaptedfor sterilization of the human female. The point 101A of this fiberoptic core 101 in combination with other structures as will be describedin connection with FIG. 11 is adapted to be maneuvered to a positionproximate to the fallopian tube opening. The other end 101B is mountedinto a handle 102 on which is an eyepiece 103, as for example, a rubbereyepiece. The entire instrument is approximately 24 inches long and thefiber optic core approximately A inch in diameter.

In FIG. 11, the fiber optic core 101 is sheathed within a plastic sheath105 to form a surgical electrode generally designated 106 and a lens 107optionally of glass or plastic is mounted at the end of the core 101 andadapted to focus an image onto the ends of the optical fibers. Mountedpiggy back on sheath 105 is an electrode sheath 108 in which ispositioned an electrode wire 109 terminating in an electrode tip 110.The wire 109 is easily slidable within the electrode sheath 108 so thatthe electrode tip may be withdrawn into resting contact with the end ofthe electrode sheath or, as shown, may be extended from the electrodesheath 109 into an operating position.

In use and operation, the electrode 106 is inserted within the uterusand guided by the doctors eye into position at the entrance to thefallopian tube. The electrode tip 110 is then extended from its sheath108 and maneuvered with optical guidance a short distance into the tube.The electrode is then energized causing electrical cauterization whollywithin the fallopian tube. Scarring results, causing complete sealing ofthe tube. When the purpose of the treatment is individual and when it isimportant to know with certainty whether sterilization has beenachieved, it is important to maintain post-operative tests and to bepreapred for hospitalized surgery if the treatment was not .effective.However, if the purpose of the treatment is solely economic, or if thepatients are not willing or able to be checked subsequently, it is stillpossible to achieve a high ratio of success and to avoid in manyinstances the need for hospitalization.

In FIGS. 12, 13, 14, and 15, is illustrated another specific electrodestructure expressly designed for a surgical or medical method or processof rendering the human female sterile. I

Referring-now to FIG. 12 in particular, the electrode or fiber opticscope including sheath assembly 141, electrode 142, light source 143,power 144 and fluid supplies 145, eyepiece focusing lenses 146 is shownin place in the uterus with electrode 140 extended as in use forcauterizing a fallopian tube 148 via the cervix 147.

Referring now to FIG. 13 in particular, there is shown the cauterizingand objective end of the sheath assembly 141 which consists of an outersheath 149, an electrode sheath 150 containing a retractable andadvanceable electrode 151 which is coated with electrical insulatingmaterial along its length but not at the tip, a fiber optics sheath 152and an objective lens or lens assembly 153. In the case where the fiberoptics 154 consists of a coherent bundle, a single objective lens willdistribute the light from the bundle to the field of view and alsoconduct the image back to the eyepiece 146. In the case where anincoherent bundle is used to light the field and a separate coherentbundle is used to conduct the image, a more complex lens 153 or lensassembly would be used. The electrode sheath, fiber optics sheath andouter sheath are made of tubing and may be bonded or fused together. Theobjective lens is fabricated separately and bonded or fused to the fiberoptics sheath. The objective lens is so designed that when the fiberoptics are in place, they abut the edge of the lens protruding into thefiber optics sheath 152 to so provide for the proper separations betweenthe end of the fiber optics and the optical surface of the lens. Thespace 158 between the fiber optics sheath 152, the electrode sheath 150and the outer sheath 149 may be used to conduct a solution into theuterus to clean the visual field at the objective lens 153. In order toprevent fiuid leakage about the electrode, a fluid-tight seal 155 may beprovided concentric to the electrode and its sheath after the electrodesheath emerges through the outer sheath proximate to the eyepiece end ofthe sheath assembly. A seal 156 is also provided to close off the waterconducting space between the fiber optic sheath 152 and the outer sheath149 at the eyepiece end of the sheath assembly.

It is possible, according to this embodiment of the invention, toproduce simple, inexpensive surgical electrode sheath assemblies at acost essentially comparable to the cost of sterilizing these sheaths.Accordingly, a new and unused and therefore sterilized electrode sheathassembly 141 may be employed on one human or animal and immediatelythereafter thrown away to permit the immediate use ofa new, andtherefore sterilized electrode sheath assembly 141. Since the electrodesheath assembly encloses that portion of the fiber optics core insertedinto the body cavity, the fiber optics need not be sterilized.

I claim:

1. A method of sterilization of a female human being, comprising guidinga source of electric discharge under direct vision to the fallopiantubes of said female, generating a cauterizing electric dischargeessentially completely, within the fallopian tubes removed'from theuterus proper and allowing interior scar tissue to form, thus sealingsaid tubes.

2. A method of sterilization of a female human being, comprisinginserting a fine electrode tip from the uterus into each fallopian tubein a manner to locate said active electrode tip within said tubeessentially at the narrowest portion of said tube, and generating acauterizing electric discharge from said electrode tip to cauterize thetissue within said tube, and allowing scar tissue to form.

3. A method of sterilization of a female animal comprising guiding asource of electric discharge under direct vision to the fallopian tubesof said female, gener ating a cauterizing electric discharge essentiallycompletely within the fallopian tubes, avoiding the uterus wall withsaid discharge and sealing said tube by allowing scar tissue to form.

4. A surgical instrument for female sterilization by sealing thefallopian tubes, means for providing a cauterizing electric generateddischarge wholly within the fallopian tube to cause tissue wall scarringand permanent blocking of said fallopian tubes comprising an elongatedelectrode ofa size to fit well within said fallopian tubes, means forproviding direct vision of the tip of said electrode to guide saidelectrode to a precise position adjacent the entrance of said tube,means to insert said tip into said tube, and means to supply an electricdischarge pulse to said electrode tip, essentially completely withinsaid tube.

5. A surgical instrument according to claim 4, wherein said means toguide said electrode comprises a fiber optics bundle for opticalillumination and observation of the position of said electrode tip andsaid electrode includes means for maneuvering said electrode tip inresponse to said optical observation, said maneuvering being from aposition outside the body.

6. A surgical instrument according to claim 5, wherein said instrumentincludes means to flush the op tical tip and visual field.

7. In a surgical instrument according to claim 5, including a removablesheath completely surround said fiber optics device to protect saidfiber optics device from contamination and containing a movableelectrode and an optical tip positionable adjacent to the fiber opticstip and means in said sheath for fluid flush ing of said optical tip andfield of observation.

1. A method of sterilization of a female human being, comprising guidinga source of electric discharge under direct vision to the fallopiantubes of said female, generating a cauterizing electric dischargeessentially completely, within the fallopian tubes removed from theuterus proper and allowing interior scar tissue to form, thus sealingsaid tubes.
 2. A method of sterilization of a female human being,comprising inserting a fine electrode tip from the uterus into eachfallopian tube in a manner to locate said active electrode tip withinsaid tube essentially at the narrowest portion of said tube, andgenerating a cauterizing electric discharge from said electrode tip tocauterize the tissue within said tube, and allowing scar tissue to form.3. A method of sterilization of a female animal comprising guiding asource of electric discharge under direct vision to the fallopian tubesof said female, generating a cauterizing electric discharge essentiallycompletely within the fallopian tubes, avoiding the uterus wall withsaid discharge and sealing said tube by allowing scar tissue to form. 4.A surgical instrument for female sterilization by sealing the fallopiantubes, means for providing a cauterizing electric generated dischargewholly within the fallopian tube to cause tissue wall scarring andpermanent blocking of said fallopian tubes comprising an elongatedelectrode of a size to fit well within said fallopian tubes, means forproviding direct vision of the tip of said electrode to guide saidelectrode to a precise position adjacent the entrance of said tube,means to insert said tip into said tube, and means to supply an electricdischarge pulse to said electrode tip, essentially completely withinsaid tube.
 5. A surgical instrument according to claim 4, wherein saidmeans to guide said electrode comprises a fiber optics bundle foroptical illumination and observation of the position of said electrodetip and said electrode includes means for maneuvering said electrode tipin response to said optical observation, said maneuvering being from aposition outside the body.
 6. A surgical instrument according to claim5, wherein said instrument includes means to flush the optical tip andvisual field.
 7. In a surgical instrument according to claim 5,including a removable sheath completely surround said fiber opticsdevice to protect said fiber optics device from contamination andcontaining a movable electrode and an optical tip positionable adjacentto the fiber optics tip and means in said sheath for fluid flushing ofsaid optical tip and field of observation.